মঙ্গলবার, ২৫ ডিসেম্বর, ২০১২

Home for the holidays ? Training Family Doctors

Cartoon A7 HouseMoving copyA fun fact: If Jesus were to go home for Christmas, He would not go to Nazareth (his boyhood home where all of His toys and books were) but to Loreto, Italy where the His house is now found:

According to some shepherds, it was seen on December 10, 1294, being borne aloft by Angels across the Adriatic sea and came to rest in a wooded area four miles from Recanati, Italy. The news spread fast and thousands came to examine the tiny house which resembled a church. The House became a place of pilgrimage and many miracles took place there. Bandits from the nearby wooded area began to plague the pilgrims, so the House was borne to a safer spot a short distance away. But the spot where the House was finally to rest was still not settled since the two brothers who owned the land were quarreling. The House was moved a third time to the site it now occupies. The brothers became reconciled as soon as the House settled in its final location. Incidentally, wherever it landed, the Holy House rested miraculously on the ground, without a foundation.

Once again miracles attended the presence of the House, and the townspeople sent a deputation of men to Tersatto and then to Nazareth to determine for certain the origin of the Holy House. Sixteen men, all reliable citizens, took with them measurements and full details of the House, and after several months arrived back with the report that in their opinion, the House had really come from Nazareth.

In the 1300s, towns and cities competed to get people to come to their market. The great cathedrals, the importation of important relics associated with the Holy Lands (such as the Holy House of Loreto), the appearance of markets, festivals, and spectacles were are intended to magnify the economic importance of the place. Today, we strongly suspect that the house came from Nazareth via boat, a dowry for the daughter of Angeli Commeno. It almost certainly was brought over as an attraction, needed to build a market and attract artisans for economic survival

My children and their friends are home for the holidays. I had a discussion with one of them disruptive technology, specifically the role of the horse:

The heavy plow made it possible to open up the fertile but heavy bottom lands of Europe, and to plow lands with a single pass rather than the criss-cross pattern the lands demanded of the scratch plough. The heavy plow required greater tractive power, and the development of metal horse-shoes, padded horse-collars, and tandem harnessing made it possible to use horses as draft animals. Horses were not only faster (plowing 30+ % more in a day than oxen) but were more intelligent than oxen and so did not need the attention of a man wielding a goad to direct them. The peasants discovered the value of leguminous crops (peas and beans) in restoring soil fertility, and ? although they did not realize it ? improved the human and animal diet of western Europe with the addition of the relatively high grade of protein provided by peas and beans. The deep plow and the use of legumes made it possible to change the two-field system, in which 50% of the arable land was put in fallow each season, to a three-field-system, in which only 33% of the land needed to be in fallow in order to restore its fertility and to kill off the growth of weeds.

The ability to feed so many people with so little labor opened up the concept of commerce, created an artisan class, and ultimately lead to the downfall of the existing social structure. The need to get people, who were much more mobile, to come to your town created great competition. This competition lead to dramatic changes in building, arts, and commerce. The Renaissance happened, in part, as a result of this disruption in the social order.

American medicine is undergoing a period of disruptive innovation. The development of data interpretation (analytics) will allow us to deliver care much more efficiently and effectively. In fact, where healthcare currently uses up 18% of our domestic economic output, it could go down to as little as 4% (the amount Singapore spends to achieve health outcomes better than ours) freeing up folks who ?labor? in healthcare to do other things. One has to wonder; what will come as a result?

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Source: http://usafamilymedicine.wordpress.com/2012/12/24/home-for-the-holidays/

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